title: Rockall score in predicting outcomes of elderly patients with acute upper gastrointestinal bleeding.
abstract: OBJECTIVE
  To validate the clinical Rockall score in predicting outcomes (rebleeding, surgery and mortality) in elderly patients with acute upper gastrointestinal bleeding (AUGIB).
  
  
  METHODS
  A retrospective analysis was undertaken in 341 patients admitted to the emergency room and Intensive Care Unit of Xuanwu Hospital of Capital Medical University with non-variceal upper gastrointestinal bleeding. The Rockall scores were calculated, and the association between clinical Rockall scores and patient outcomes (rebleeding, surgery and mortality) was assessed. Based on the Rockall scores, patients were divided into three risk categories: low risk ≤ 3, moderate risk 3-4, high risk ≥ 4, and the percentages of rebleeding/death/surgery in each risk category were compared. The area under the receiver operating characteristic (ROC) curve was calculated to assess the validity of the Rockall system in predicting rebleeding, surgery and mortality of patients with AUGIB.
  
  
  RESULTS
  A positive linear correlation between clinical Rockall scores and patient outcomes in terms of rebleeding, surgery and mortality was observed (r = 0.962, 0.955 and 0.946, respectively, P = 0.001). High clinical Rockall scores > 3 were associated with adverse outcomes (rebleeding, surgery and death). There was a significant correlation between high Rockall scores and the occurrence of rebleeding, surgery and mortality in the entire patient population (χ² = 49.29, 23.10 and 27.64, respectively, P = 0.001). For rebleeding, the area under the ROC curve was 0.788 (95%CI: 0.726-0.849, P = 0.001); For surgery, the area under the ROC curve was 0.752 (95%CI: 0.679-0.825, P = 0.001) and for mortality, the area under the ROC curve was 0.787 (95%CI: 0.716-0.859, P = 0.001).
  
  
  CONCLUSIONS
  The Rockall score is clinically useful, rapid and accurate in predicting rebleeding, surgery and mortality outcomes in elderly patients with AUGIB.
authors.affiliation: Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
authors.forename: Chang-Yuan
authors.initials: CY
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Qin
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Chang-Yi
authors.initials: CY
authors.lastname: Sun
authors.forename: Tao
authors.initials: T
authors.lastname: Cao
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Zhu
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016009:Chi-Square Distribution; D002681:China; D003661:Decision Support Techniques; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D006489:Hemostatic Techniques; D006785:Hospitals, University; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012008:Recurrence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Acute upper gastrointestinal bleeding; Elderly patients; Prognosis; Rockall score